Introduction: Almost everything we know about visual functions in amblyopia other than visual acuity comes from adults, studied long after initial onset and often treatment of the disorder. Studies indicate that vernier and optotype measures are correlated in amblyopic adults. Here, we report fundamental differences between children and adults with strabismic amblyopia.

Results: Despite significant optotype acuity deficits and favorable treatment response (p<0.05); vernier response functions were not significantly different between a) the preferred and amblyopic eyes of strab-amb. children; b) either eye of strab-amb. group vs. control children; and c) stable vernier response after treatment in strab-amb. group.

Discussion: Vernier response in previously untreated strab-amb. children is unaffected, in contrast to the clear deficits reported in previously treated adults with the same amblyopia subtype and in children with anisometropic amblyopia of the same age. The difference between adult and child strabismic amblyopes may indicate differential amblyogenic processes at different stages of cortical involvement and in different etiologies.

Conclusion: Vernier sVEP function is spared in children with reductions in optotype acuity in untreated recent onset strabismus. These data underscore the need for caution when applying ‘one size fits all’ treatment regimes – at least in developing visual systems.